Provider Demographics
NPI:1518057009
Name:WONG, EMILY BETH (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:BETH
Last Name:WONG
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:BETH
Other - Last Name:KAZMIERSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR STE 701
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3940
Mailing Address - Country:US
Mailing Address - Phone:808-888-3311
Mailing Address - Fax:808-888-3315
Practice Address - Street 1:99-128 AIEA HEIGHTS DR STE 701
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3940
Practice Address - Country:US
Practice Address - Phone:808-888-3311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR8511207N00000X
HIMD-13951207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery